Health Insurance in Kansas

Navigate Through Insurance Mayhem

Tired of Constantly Jumping Through Hoops?

Accessing affordable health insurance in Kansas is complete chaos. From group/employer-sponsored health insurance to individual health insurance, consumers continue to tirelessly navigate the ever-changing insurance industry – and with limited options for success. In 2017, the state of Kansas offered only two provider options outside of Johnson and Wyandotte Counties –Medica and Blue Cross and Blue Shield of Kansas (BCBSKS).

So, if those are my two options, who should I choose? The golden question. Well, your options are as big as your checkbook.

The Blue Cross plans are cheaper but they only have HMO networks which can cause big problems for a lot of consumers. If consumers could afford it, they went to Medica which was the only PPO provider in the state outside of Johnson and Wyandotte county. Unfortunately, Medica plans were extremely expensive.

Within Johnson and Wyandotte Counties, Blue Cross and Blue Shield of Kansas City (BCBSKC) offered plans with their PPO networks – Preferred Care Blue and Blue Select. These plans were good options for consumers that lived within these counties if they could afford the steep prices.

Recently, Blue Cross and Blue Shield of Kansas City announced it will not offer individual Affordable Care Act (ACA) plans in 2018. This means all individual Blue Cross and Blue Shield plans will not be available. This leaves only one carrier in the whole state of Kansas that offers a PPO network.

BCBS Kansas City vs. BCBS Kansas

Blue Cross and Blue Shield (BCBS) is one of the biggest branded health insurance carriers in the United States. BCBS is broken up into 36 different independent and locally operated companies scattered across the United States. Blue Cross has a presence in almost every state providing benefits to individuals, federal employees, and retirees. Historically in the state of Kansas, two Blue Cross carriers existed Blue Cross and Blue Shield of Kansas (BCBSKS) and Blue KC (BCBSKC).

Blue Cross and Blue Shield of Kansas (BCBSKS) and Blue KC (BCBSKC) have no ties to one another other than the name. However, like in most states with multiple Blue Crosses, BCBSKC and BCBSKS have an agreement not compete with each other.

Who does BCBS Kansas City serve? And how is it different from BCBS Kansas?

BCBSKC can offer plans around the Kansas City area both on the Missouri and Kansas side of the state line. Which means BCBSKC controls the Johnson and Wyandotte counties of Kansas while BCBSKS can control the other counties within the state.

Post ACA, the plans are drastically different.

Historically speaking, Blue Cross has been one of the best carriers to join for benefits throughout the state of Kansas. A lot of the plans offered by both of these carriers used to have similar benefits, but that is no longer the case. With the passing of the Affordable Care Act, plans provided by BCBSKS and BCBSKC have changed drastically and no longer offer similar benefits.

Changes in Regulations are Costing Healthcare Carriers Millions.

Currently, one of the biggest differences between the two carriers and the plans offered are the networks. As we have seen over the years with “Obamacare”, the plan has not provided carriers with a way to exist without losing millions of dollars.

We’ve noticed a huge trend: healthcare rates are increasing and making it more difficult for carriers to provide benefits that work for consumers and that are affordable.

The frustrating part for the carriers is that even after raising premiums, raising deductibles and decreasing benefits they are still losing money and going out of business. The frustrating part for consumers is that we can’t get affordable plans that cover us for the reasons we want coverage. This has proved to be a lose-lose situation for most consumers.

Why is health insurance so expensive?

Other than the fact that health insurance carriers now have to cover ALL pre-existing conditions no matter how expensive the condition is to treat, there are other factors that contribute to the rising rates of health insurance. One of the biggest contributors to the cost of healthcare for carriers is the network they provide. The bigger the network, the more expensive it is to offer that network to their clients – the smaller the network, the less expensive it is.

This is one way BCBSKS is different than BCBSKC plans:

BCBSKS only offers HMO networks to individuals.

BCBSKC offers two separate PPO network options on their plans. One of the PPO networks is extremely small and the other is their best and biggest PPO network.

This is one of the biggest benefits to understand when you’re trying to pick affordable health insurance in Kansas. As stated previously on our blog, HMO and PPO Networks, we described the in-depth differences between HMO and PPO networks. In addition, we also stated why it is important to know your network.

HMO

Here’s a quick recap – HMO networks are more restrictive and confine you within the state to receive care. HMO networks in the state of Kansas do not have access to Children’s Mercy, KU Medical Center, St. Luke’s, Mayo Clinic, and any other hospital outside of the state.

PPO

The PPO networks within the state of Kansas allows you to use outside of the state providers like KU Medical Center, Children’s Mercy, St. Luke’s, Mayo Clinic, and many more hospitals and facilities.

Providers used to be abundant, deductibles were lower, and premiums were MUCH lower. Carriers like Blue Cross Blue Shield, United Healthcare, Aetna, Assurant, and Coventry provided health insurance to the residents of Kansas. With the implementation of the ACA, insurance companies lost money and lost money fast. Two of the largest health insurance carriers in the United States, United Healthcare and Aetna, removed almost all plans from the ACA for 2017.

The closing of Assurant Health was a big wake up call.

In the early days of the ACA, one of the biggest surprises was the closing of Assurant Health. As stated in Modern Healthcare, Assurant was expecting to lose between $80 and $90 million within the first quarter of 2015 on claims. With these strict requirements put in place by the ACA, insurance carriers are losing money yearly in the individual market.

Even though premiums have increased drastically, they still do not account for the carrier’s losses as it pertains to money spent on claims. One of the biggest shocks to the market is when BCBSKC recently stated they are no longer offering plans to individuals in 2018. Blue KC, one of the area’s top insurers, have lost over $100 million since the implementation of the ACA.

“This is unsustainable for our company. We have a responsibility to our (customers) and the greater community to remain stable and secure, and the uncertain direction of this market is a barrier to our continued participation”.

Danette Wilson,CEO and president of Blue KC

Quick History of Group Plans

The ACA not only has affected individual plans but it has also affected employer-sponsored plans as well. With all of the changes to the law that implements guarantee-issued plans, requirements of maximum deductibles, maximum out of pocket expenses, as well as a host of other implementations costs for employers and their employees have skyrocketed. This has drastically affected small businesses and their ability to offer affordable and decent coverage to their employees. Many small businesses have been forced to no longer offer health benefits because of these ridiculous rising rates. This is a massive problem for many small businesses. Businesses like these have had to cancel their health benefits, resulting in the loss of key employees. This has simply crushed many small businesses.

As mentioned above, there are few options available for affordable health insurance in Kansas in 2017. Depending on where you are in the state, the options available to you are Medica or BCBSKS / BCBSKC.

And Limited Market Guidance

As of now, for 2018, your only ACA compliant options are going to be BCBSKS or Medica. Because of the volatility of the market, nearly half the brokers have left the industry since the implementation of the ACA. This is leaving consumers blind.

Leaves You With Tough Decisions.

For many people, health insurance is one of the most important aspects to keep their families safe, happy, and covered. Unfortunately, with the number of changes, carriers dropping, and new rules, it is nearly impossible for consumers to be well-informed and make the best decision for their family as it pertains to making sure their health is covered.

With all these changes, people are looking to brokers for help. Sadly, there is a lack of available brokers around to service the consumer. Most of the brokers in the market have no affordable solutions to offer their clients.

Most group health insurance plans in Kansas are through one of two carriers: Aetna and Blue Cross. These carriers have proved to provide excellent coverage at great prices. However, there is news that employers need to be aware of as it pertains to affordable health insurance in Kansas, especially if they have BCBSKS or Aetna.

In 2017, All Grandfathered Group Plans will be Terminated.

That’s right. Upon renewal, ALL grandfathered in group plans will be terminated. BCBSKS decided that they could no longer offer their grandfathered groups plans. Why is this important? Grandfathered group plans are much cheaper and provide very good benefits for employees. Non-grandfathered plans are typically fully-insured, ACA-compliant plans with high premiums.

What does this mean for BCBSKS and Aetna? When employers renew their plans in 2017 with BCBSKS, their jaws will drop at their rate increase.

Surprisingly, when employers get their renewal notices this year with Aetna, they will probably be pleased with the rates that will be offered. With a quick glance, it looks like great news. However, if you look deeper you will see that these plans are ALL going to HMO networks. Aetna will no longer offer a plan with a PPO network upon renewal in 2017 / 2018.

You need a broker looking out for you.

In all of this mayhem, individuals need an expert in the industry navigating regulations and providing clear and affordable solutions. Unfortunately, brokers are not keeping up with industry news and most of the time employers don’t understand the differences between HMO and PPO networks.

This means that thousands of employees will be suffering from the consequences of these changes. Remember, if you or a loved one get diagnosed with a serious illness and you need to go to MD Anderson, Mayo Clinic, Children’s Mercy, etc. you or your loved one will not be able to receive care from those facilities because they are out of state and/or out of network.

Due to this incredibly turbulent time in the industry, several new carriers are emerging with excellent plan offerings. These types of plans work a little differently than the ACA plans. Many agents in the industry are not staying up-to-date with these types of carriers.

At Apollo Insurance, we make sure we are up-to-date with the latest trends in the market and the shifts in the future. We stay informed and on the cutting edge of affordable health insurance in Kansas. No matter what the government mandates, repeals, or puts in place we have solutions for everyone!